• Alonso Montoya, Magdalena Ocampo, and Antonio Torres-Ruiz.
• Brain Imaging Group, Douglas Hospital Research Centre, McGill University, 6875 Boulevard LaSalle, Verdun, Quebec H4H 1R3, Canada. alonzo.montoya@douglas.mcgill.ca
• Can J Clin Pharmacol. 2003 Jan 1; 10 (3): 111-3.

BackgroundNeuroleptic Malignant Syndrome (NMS) is an uncommon but potentially fatal complication of antipsychotic and neuroleptic drug treatment.ObjectivesThis study estimated the frequency, clinical presentation, and outcome of NMS in a referral center for neurological, neurosurgical and psychiatric disorders in Mexico.MethodsThe authors conducted a thorough search of psychiatry, neurology, neurosurgery and intensive care unit records for cases of NMS during the 10-year period between 1990 and 1999. They examined the clinical features, course and treatment of the NMS episodes, and performed a follow-up survey for residual symptoms and clinical outcome. The mean time to follow-up assessment was 36 months.ResultsA total of eight of 4831 neuroleptic-treated patients had an episode of NMS (incidence 0.165%). Seven of the eight patients were treated with haloperidol. Other neuroleptics agents associated with NMS were depot pipotiazine palmitate and levomepromazine maleate. One patient received lithium concomitantly. No fatal outcome was found. Only one patient developed persistent clinical sequelae, consisting of extrapyramidal and cerebellar symptoms, three years after the NMS episode.ConclusionsThe slightly low frequency of NMS found in this study compared with studies conducted in other countries may be attributable to the advent and use of newer atypical antipsychotics in Mexico, the rigorous demands for NMS diagnostic criteria and the lack of familiarity with the diagnosis between physicians.

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